| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.54 | $371.54 | $371.54 | |
Aetna
| Professional | $30.20 | $44.67 | $371.54 | |
Cigna
| Professional | $257.04 | $309.03 | $562.34 | |
Kaiser Permanente
| Professional | $123.03 | $173.78 | $398.11 | |
United
| Professional | $34.67 | $64.57 | $81.28 | |
University Health Alliance
| Professional | $8.71 | $48.98 | $72.44 |